Aesthetics is our constant preoccupation. It’s starting from our working environment, choice of tools and raw materials and continuing through color perception and individual natural looking and functioning design of every restoration. Perfection is achieved, not when there is nothing more to add, but when there is nothing left to take away. ”Antoine de Saint-Exupery”
Creativity is our favoured means of affirmation. Mark Twain said: You cannot depend on your eyes when your imagination is out of focus. Every day in our dental laboratory in Montreal we are imagining, pushing the boundaries of traditional designs and finding new solutions, for each case is unique. We are always looking for challenges, no matter how difficult or unusual.
In 2007 we became North America’s first full service full Zirconia lab. Later in the same year, our dental laboratory was first in the world to start exploring and creating monolithic Zirconia restorations. We’ve helped develop the monolithic Zirconia line for major companies. Today, all cases in our dental studio are done in monolithic Zirconia. We are taking it further every day, making it the ultimate material for future dentistry. The future is here. It’s just not widely distributed yet. ”William Gibson”
An expert is a man who has made all the mistakes that can be made in a very narrow field. ”Niels Bohr” Our Master Zirconist, Haim Keren is an expert in Zirconia restorations. Second generation dental technician, his expertise is a result of thirst for knowledge, relentless desire to improve and meticulous approach to every stage of the restoration. Since his early days as a technician, Haim was envisioning full ceramic, high tech dentistry. Today he makes his vision reality through his consistent work at our dental laboratory in Montreal. Thanks to visionaries like Haim the dental profession is moving forward.
The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn. ”Alvin Toffler” We are constantly researching and exploring, remaining on the edge of dental innovations. Staying idle is not an option because we live in a moment of history where change is so speeded up that we begin to see the present only when it is already disappearing. ”R. D. Laing”
WHY CHOOSE MONOLITHIC ?
Sintered dental zirconia has whiteness and translucency that very much resembles a natural tooth. Therefore, it is easy to achieve very aesthetic result in full contour zirconia restorations. Monolithic zirconia restoration is the most solid restoration possible. As there is no chemical bond between zirconia and ceramic, any porcelain on functional surface might delaminate in the course of time. This is especially true for posterior crowns and implant based restorations. Sintered zirconia is a very dense and highly acid proof material which prevents the absorption and surface accumulation of pollutants (like plaque). Monolithic zirconia restorations give a patient amazing “clean” sensation and greatly contribute to healthy tissues. The main objection to monolithic restorations comes from the perception that they are too abrasive for the opposing natural teeth. We should
Zirconia made a significant appearance on the dental horizon about 5 years ago. It provided an alternative for all ceramic crowns and bridges. Today, a milling procedure is the only reliable way to create zirconia restorative components for dental use. The availability of computer numerical controlled machines (CNC) allows for highly automated end-to-end component design using computer aided design and computer aided manufacture (CAD/CAM) programs. The programs produce a computer file that is interpreted to extract the commands needed to operate a particular machine, and then loaded into the CNC machines for production of the restoration coping or framework.
When All Else Fails
The following article is a case history from the office of Dr. Sylvio Caro, a prosthodontist from Westmount, Canada.
The patient, a 72 year old male, arrived to our clinic with a failing maxillary restoration on implants (hybrid bar on 10 Zimmer implants). When the restoration was removed for evaluation the reason for the failure became apparent.
The case presented here is one in which a novel solution was achieved utilizing zirconia in a very challenging situation. The patient is a 70+ year old woman who had a history of multiple implant procedures over the past 18 years and had never made it past the temporary restorations due to complications with the implants.
Protocol for creating z-bridge (full contour designer zirconia bridge) on implants
White Possibilities - Dental Labor
Bei der Patientin handelte es sich um eine über 70 Jahre alte Frau, die in den vorangegangenen 18 Jahren schon mehrfach implantologisch behandelt worden war. Aufgrund von Komplikationen mit ihren Implantaten war sie nie über das Stadium der provisorischen Versorgung hinausgekommen.
The Zirconia Experience - Technical Insights
Диоксид циркония (ZrO2), или просто цирконий, — это кристал- лический оксид циркония белого цвета. На данный момент он является наиболее изучаемым керамическим материалом в стоматологии. Многие специалисты внедряют этот материал в свою практику, причем с различным успехом. Главный вопрос, которым сейчас задаются все специалисты, звучит так: является ли использо- вание циркония новой тенденцией или временной причудой?
Interview With Haim Keren, Founder Of Kerenor Dental Studio By Wolfgang Friebauer, Glidewell Laboratories
Haim Keren, MDT, CDT, is the founder of Kerenor Dental Studio, a high-end dental laboratory located in Montreal, Canada, that delivers world-class restorations with premium esthetics and function. As an expert in zirconia restorations, Haim has contributed to the development of both the technology and methodology utilized in fabricating zirconia for the dental industry. Read on for some exclusive technical pointers on how to guarantee success in your monolithic zirconia restorations.
Stereolithography (SLA) is the original 3D printing — or rapid prototyping — technology and is widely used today in a large variety of applications due to its efficacy in producing accurate details and a superb material finish. Thanks to advancements in both mechanical engineering and digital processes, stereolithography is a highly-valued asset in the production of sophisticated dentistry models that may be impossible to match with traditional prototyping practices.
Possibilities with Dental Zirconia
Zirconia is revolutionizing traditional dentistry as a safe, durable and enduring alternative to standard implant materials such as porcelain and acrylics. These materials have been the only answer to dental implant needs for decades and have served the industry in their role as the primary solution for dental crowns, bridges and dentures.
Reliability of Zirconia Restorations
Zirconia is a fully biocompatible material and poses no harm or risk of complications when exposed to living tissue for long periods of time. It is perfectly safe and maintains a smooth surface throughout its lifespan, preventing any irritation or abrasion of surrounding tissue or teeth.
KERENOR DENTAL STUDIO
1310 GREENE AVENUE, SUITE 540WESTMOUNT, QC, H3Z 2B2
Sintered dental zirconia has whiteness and translucency that very much resembles a natural tooth. Therefore, it is easy to achieve very aesthetic result in full contour zirconia restorations. Monolithic zirconia restoration is the most solid restoration possible. As there is no chemical bond between zirconia and ceramic, any porcelain on functional surface might delaminate in the course of time. This is especially true for posterior crowns and implant based restorations. Sintered zirconia is a very dense and highly acid proof material which prevents the absorption and surface accumulation of pollutants (like plaque). Monolithic zirconia restorations give a patient amazing “clean” sensation and greatly contribute to healthy tissues. The main objection to monolithic restorations comes from the perception that they are too abrasive for the opposing natural teeth. We should not confuse the strength of zirconia with abrasiveness. The surface of zirconia is very dense, smooth, stable and non-aggressive. In the studies done in recent years it was proven that monolithic zirconia is the least abrasive of all restorative materials and even less abrasive then natural teeth.
Q: Do zirconia crowns require special prep ?
A: No. Today’s process of creation of zirconia crowns allows accepting all preparation styles and guarantee exceptional fit (marginal and otherwise). With monolithic zirconia, prep can be very conservative. With as little as 1 mm clearance beautiful and very solid monolithic crown can be created.
Q: Do I need to use a water-spray turbine to grind zirconia ?
A: Yes. Zirconia is a very bad heat conductor. Grinding without water-spray can create an extremely hot spot on the surface of the crown (over a 1,000º C). At those temperatures the structure of zirconia in this spot can change, which will lead to creation of micro cracks and weakening of the restoration.
Q: Do I need to use special tools to work on zirconia crown ?
A: We recommend using fine diamonds for zirconia. Fine bur will remove/cut zirconia very well and will last longer. Medium or rough burs get clogged fast with fine zirconia dust and will not remove material, but unnecessary overheat the surface.
Q: Can zirconia restorations be done on any type/brand of implants ?
A: Yes. In our dental studio, we have no limitation in implant type or brand. In accordance with the case, direct screw retained or cemented crown on custom or prefabricated abutment can be realized on any implant system.
Q: Are there any limitation to a size of span for zirconia restoration or the number of pontics in zirconia bridge?
A: There’s no limit to the span of a zirconia bridge or to the amount of pontics. The only condition is the right design. The larger the distance between the abutments the taller and wider the connectors should be. However, in light of the stability of this material, sound dental principles should be adhered to. In our studio we are routinely creating one piece full arch restorations and can report success since 2007. We’ve created very clear protocols for successful long span restorations and can guarantee any case that in made in our studio.
Q: What type of cement should be used for zirconia restoration ?
A: In principle, zirconia restorations can be conventionally fixed in place using any dental cement. However, it needs to be noted that zirconia does not etch, therefore for inlays and onlays, as well as for maryland bridges, additional mechanical retention should be created in preps and in the restoration.
Kerenor dental laboratory is equipped to accept intraoral scans from any open intraoral scanners. Scans can be sent via email or via system inboxes (depends on set-up of specific scanner).
If the restoration has implants, please contact usin advance for preferred scan bodies and analog systems.
IN HOUSE STEREOLITHOGRAPHY
Stereolithography (SLA) is the oldest rapid prototyping technology, but it’s still widely used thanks to its ability to obtain fine detailed parts and excellent surface finish. SLA machines can even create oddly shaped objects, which can be difficult to produce using traditional prototyping methods. SLA is an excellent choice where an extremely high level of detail and high accuracy is desired.
In our studio we use in-house SLA machine to create our models from digital impressions. Our machine uses special polymer with excellent properties for dental models.